Rajasthan Health Scheme Cracks Down on Fraud: 34 Hospitals, 431 Pharmacies Suspended

The Rajasthan Government Health Scheme (RGHS) has taken significant action against fraudulent practices, leading to the suspension of 34 hospitals and 431 pharmacies over the past three months. The health department also suspended 28 government employees and initiated 17 First Information Reports (FIRs) to address the misuse of the scheme.

Authorities reported receiving multiple complaints regarding irregularities involving hospitals, pharmacies, and government personnel. These practices have adversely impacted the effectiveness of the RGHS. Following a special audit and thorough investigation, officials enforced strict measures against all entities deemed prima facie guilty of fraud.

Establishment of an Anti-Fraud Cell

To prevent future violations, an Anti-Fraud Cell has been established. The health minister, Gajendra Singh Khimsar, indicated that a new Standard Operating Procedure (SOP) will soon be introduced to enhance monitoring and oversight of the scheme. Increased surveillance was implemented in recent months to protect public funds and ensure the smooth operation of the RGHS.

During this period, numerous cases emerged involving private hospitals and approved pharmacies. These entities were found to be exploiting the system by engaging in improper practices that resulted in significant financial losses to the scheme.

Principal Secretary for Health, Gayatri Rathore, stated that the suspensions of the 34 hospitals were primarily due to their involvement in practices such as submitting double claims for a single surgery, conducting unnecessary medical tests, and billing for higher-rate test packages instead of utilizing lower-rate options that were available.

So far, penalties amounting to ₹36 crore have been recovered from these hospitals. Similarly, the 431 pharmacies faced suspension for issuing fraudulent bills and misusing RGHS benefits, often in collusion with doctors and beneficiaries. In these cases, the department has recovered ₹4.6 crore in penalties.

Blocking of Fraudulent Claims

In addition to the suspensions and financial recoveries, the health department has blocked over 1,000 RGHS beneficiary cards that were used in fraudulent claims. The action against the 28 suspended government employees further underscores the department’s commitment to addressing corruption within the scheme.

The response from the Rajasthan health authorities highlights an increased effort to maintain the integrity of the RGHS. By implementing strict measures and enhancing monitoring, officials aim to ensure that the scheme provides genuine support to those in need while safeguarding public resources.